Citrobacter freundii causing pharyngitis and secondary retropharyngeal abscess with intrathoracic extension to the diaphragm: minimally invasive management of a rare case.

INTRODUCTION

Citrobacter freundii is a rare but potentially aggressive cause of pharyngitis which may progress to retropharyngeal abscess with diaphragmatic extension.

OBJECTIVE

To raise awareness of: (1) citrobacter as a potential cause of head and neck infection, including retropharyngeal abscess; (2) a novel surgical approach to draining such an abscess; and (3) citrobacter's particular biological properties which may affect the clinical course.

METHOD: Case report.

RESULTS

The abscess was drained via a minimally invasive posterior pharyngeal wall incision and placement of a suction catheter into the mediastinum through this incision. Residual intrathoracic collections were drained by the cardiothoracic team via percutaneous aspiration. The patient made a full recovery.

CONCLUSION

Early recognition of citrobacter head and neck infections, an awareness of the peculiarities of the clinical course of such infections, and timely surgical intervention can prevent catastrophic outcomes. A minimally invasive approach to mediastinal collections can be considered as a viable alternative to open thoracotomy, which carries a high morbidity rate.